Perioperative Metformin Treatment to Reduce Postoperative Hyperglycemia After Colon Cancer Surgery: A Randomized Clinical Trial.

IF 3.2 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Diseases of the Colon & Rectum Pub Date : 2024-11-01 Epub Date: 2024-07-31 DOI:10.1097/DCR.0000000000003426
Emilie Palmgren Colov Tauby, Rasmus D Bojesen, Camilla Grube, Rebecca E G Miedzianogora, Fatima Buzquurz, Tina Fransgaard, Filip K Knop, Ismail Gögenur
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引用次数: 0

Abstract

Background: Surgery induces a stress response, causing insulin resistance that may result in postoperative hyperglycemia, which is associated with increased incidence of complications, longer hospitalization, and greater mortality.

Objective: This study examined the effect of metformin treatment on the percentage of patients experiencing postoperative hyperglycemia after elective colon cancer surgery.

Design: This was a randomized, double-blind, placebo-controlled trial.

Settings: The study was conducted at Slagelse Hospital in Slagelse, Denmark.

Patients: Patients without diabetes planned for elective surgery for colon cancer were included.

Interventions: Patients received metformin (500 mg 3× per day) or placebo for 20 days before and 10 days after surgery.

Main outcome measures: Blood glucose levels were measured several times daily until the end of postoperative day 2. The main outcome measures were the percentage of patients who experienced at least 1 blood glucose measurement >7.7 and 10 mmol/L, respectively. Rates of complications within 30 days of surgery and Quality of Recovery-15 scores were also recorded.

Results: Of the 48 included patients, 21 patients (84.0%) in the placebo group and 18 patients (78.3%) in the metformin group had at least 1 blood glucose measurement >7.7 mmol/L ( p = 0.72), and 13 patients (52.0%) in the placebo group had a measurement >10.0 mmol/L versus 5 patients (21.7%) in the metformin group ( p = 0.04). No differences in complication rates or Quality of Recovery-15 scores were seen.

Limitations: The number of patients in the study was too low to detect a possible difference in postoperative complications. Blood glucose was measured as spot measurements instead of continuous surveillance.

Conclusions: In patients without diabetes, metformin significantly reduced the percentage of patients experiencing postoperative hyperglycemia, as defined as spot blood glucose measurements >10 mmol/L after elective colon cancer surgery. See Video Abstract .

围手术期二甲双胍治疗降低结肠癌术后高血糖:随机临床试验。
背景:手术会诱发应激反应,引起胰岛素抵抗,从而可能导致术后高血糖,而高血糖与并发症发生率增加、住院时间延长和死亡率升高有关。目的:本研究探讨了二甲双胍治疗对结肠癌择期手术后出现术后高血糖的患者比例的影响。干预措施:患者在手术前 20 天和手术后 10 天接受二甲双胍(500 毫克,每天 3 次)或安慰剂治疗。主要结果指标:每天多次测量血糖水平,直到术后第 2 天结束。结果:在纳入的 48 名患者中,安慰剂组 21 名患者(84.0%)和二甲双胍组 18 名患者(78.3%)至少有一次血糖测量值大于 7.7 mmol/L(P = 0.72),安慰剂组 13 名患者(52.0%)测量值大于 10.0 mmol/L,二甲双胍组 5 名患者(21.7%)测量值大于 10.0 mmol/L(P = 0.04)。在并发症发生率或恢复质量-15 评分方面未见差异。局限性:研究中的患者人数太少,无法检测出术后并发症方面可能存在的差异。结论:在没有糖尿病的患者中,二甲双胍能显著降低术后高血糖患者的比例,高血糖的定义是选择性结肠癌手术后点滴血糖测量值>10 mmol/L。请参阅视频摘要.围手术期使用二甲双胍治疗以减少结肠癌手术后高血糖的随机临床试验:背景:手术会引起应激反应,导致胰岛素抵抗,从而导致术后高血糖。设计:这是一项随机、双盲、安慰剂对照试验。患者:计划接受结肠癌择期手术的无糖尿病患者。干预:患者在手术前 20 天和手术后 10 天接受二甲双胍治疗,每次 500 毫克,每天三次,或服用安慰剂。主要结果指标是至少有一次血糖测量值超过 7.7 mmol/l 和 10 mmol/l 的患者比例。此外,还记录了术后 30 天内的并发症发生率和恢复质量-15 评分。结果:在纳入的48名患者中,安慰剂组有21人(84.0%)和二甲双胍组有18人(78.3%)至少有一次血糖测量值超过7.7毫摩尔/升(P = 0.72),安慰剂组有13人(52.0%)血糖测量值超过10.0毫摩尔/升,二甲双胍组有5人(21.7%)血糖测量值超过10.0毫摩尔/升(P = 0.04)。局限性:该研究的患者人数太少,无法检测出术后并发症的可能差异。结论:在没有糖尿病的患者中,二甲双胍能显著降低术后高血糖患者的比例,高血糖是指选择性结肠癌手术后血糖测量值超过10毫摩尔/升。 翻译:Yolanda Colorado博士)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
7.70%
发文量
572
审稿时长
3-8 weeks
期刊介绍: Diseases of the Colon & Rectum (DCR) is the official journal of the American Society of Colon and Rectal Surgeons (ASCRS) dedicated to advancing the knowledge of intestinal disorders by providing a forum for communication amongst their members. The journal features timely editorials, original contributions and technical notes.
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